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Immune mechanisms in pediatric neuropsychiatric disorders. Tourette's syndrome, OCD, and PANDAS

R R Trifiletti1, A M Packard

  • 1Department of Neurology, Joan and Sanford I. Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, USA.

Child and Adolescent Psychiatric Clinics of North America
|December 20, 1999
PubMed

Insights

Research suggests immune system abnormalities may play a role in Tourette Syndrome (TS) and Obsessive-Compulsive Disorder (OCD), especially in children. Identifying these immune markers could lead to new diagnostic and treatment approaches.

Area of Science:

  • Neuroimmunology
  • Child and Adolescent Psychiatry
  • Neuropsychiatric Disorders

Background:

  • Growing evidence suggests immune system dysfunction in neuropsychiatric disorders like Tourette Syndrome (TS), Obsessive-Compulsive Disorder (OCD), and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS).
  • A subset of patients with TS and OCD (approximately 10%) exhibit a clear streptococcal trigger, supporting the PANDAS concept.

Purpose of the Study:

  • To review recent data on immune abnormalities in TS, OCD, and PANDAS.
  • To explore the potential diagnostic and therapeutic implications of identifying immune markers in these conditions.

Main Methods:

  • Literature review of recent scientific data.
  • Analysis of emerging biochemical markers such as D8/17 and antibrain antibodies.

Main Results:

  • Evidence supports immune abnormalities in TS, OCD, and PANDAS.
  • Biochemical markers (D8/17, antibrain antibodies) suggest similar immune involvement in idiopathic TS and OCD cases.
  • A streptococcal trigger is identified in a subset of TS and OCD patients, validating the PANDAS concept.

Conclusions:

  • Identifying specific immune abnormalities in TS and OCD could significantly impact diagnosis and treatment, particularly for pediatric patients.
  • These findings may offer new therapeutic avenues for children with neuropsychiatric disorders who are unresponsive to conventional treatments.

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